Very badly damaged nose after a previous single procedure which required a revision rhinoplasty of very high difficulty.
The last three sets of images are extraordinarily meaningful since they depict, on the left frame, the naturally born nasal situation prior to the bad initial rhinoplasty, the middle frame shows the disastrous result of such bad nose job just before the revision rhinoplasty applied, and the right end frame is the post revision outcome.
The naturally born nose was already a case of high difficulty, showing hanging columella, alar rim retraction due to poor support, over projected tip, too sharp tip and a very difficult dorsal rhombus with an almost humpless dorsum which, otherwise, has a minimal excess and visible side dorsum ridges; the case would have required highly skilled open structure rhinoplasty to perform an aggressive deprojection of the tip, smoothening and rounding of tip shape, resupporting the alae and treat the retraction of their rims; the dorsum needed very slight lowering by shaving however the dorsal rhombus required custom paramedial resection of the cartilaginous middle vault plus resection of a bony wedge at the osseous synostosis of the upper half of the nasal pyramid; finally internal osteotomies or infractures should have been applied to close the roof, which is a maneuver always lowering about one or two millimeters the dorsum; spreader grafts would have been necessary because of the excessively narrow or pinched middle vault or supratip, placed between the upper lateral cartilages and the cartilaginous septum in order to provide stability to the middle vault and a right width according the upper vault; tongue in groove maneuver was indicated to correct the over exposed columellar show or hanging columella.
That would have been an ideal procedure; unfortunately things were managed in a very different manner.
The surgeon attempted to get rid of the dorsal rhombus by scooping the dorsum and removing a nonexistent hump, which lead to a severely sunken saddle nose deformity due to over resection of the dorsum; failed to perform the mandatory osteotomies to close the roof, which produced open roof deformity, broad osseous dorsum and the always associated to open roof deformity in inverted V and subsequent pinched middle vault, needless to say the spacer or spreader grafts were not used; the surgeon trimmed the caudal septum with no logic to do so, ending in a upturned or piggy nose, the tip was not deprojected, neither was the tip shape modified which lead to a tombstone deformity due to over definition of the tip, the lateral cruras were trimmed which aggravated the alar rim retraction and the hanging columella; in brief, no open structure rhinoplasty techniques were employed, no grafting applied plus a non judicious planning and execution lead to a sever deformity.
The revision began with meticulous access, debridement or removal of unsuitable tissues and non viable elements, visual diagnosis and intraoperative planning of the strategy; it was clearly stated the septum was over resected at its lower or caudal portion, so first step was applying septal lengthening by one on one method with a graft harvested from the deep septum; grafting was also harvested from both ears concha bowls; then the lateral cruras were regularized and made even, the tip modified and worked on; deprojection of the tip pillars was also done; then two spacer grafts applied at the middle vault to correct the pinching and the inverted V deformities; osteotomies performed to close the roof at the dorsum and obtain stability; tongue in groove maneuver was used to secure the middle cruras to the newly lengthened and grafted septum, thus correcting the hanging columella; caudal extension grafts of the lateral cruras were used to push down the alar rims and correct the poor alar support.
Finally, once the nose was fully stabilized and all the issues corrected, the dorsum had to be rebuilt and raised by an entire dorsum replacement graft from radix to tip, made of ear cartilage assembling 3 pieces with fine suturing; due to the transparency of the nasal dorsum skin a superficial temporal fascia graft was applied between the skin and the dorsal graft so that any potential tombstone visibility would be prevented.
The final result is a perfectly triangular profile, well supported, shaped and positioned tip, the columella and the alae have been corrected and the brand new dorsum is undetectable, there are no traced of the open roof deformity, the inverted V deformity, the saddle nose deformity, the pinched middle vault or the piggy nose, leading to a brilliant and feminine outcome after a very long time consuming and highly skills demanding revision rhinoplasty.
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All the prices and quotations visible on our website belong to or are calculated out of the reduced price list and do already enjoy by default a -20% discount from the standard price list for our treatments as compensating remuneration for the release and transfer of the intellectual property, the rights of image, the medical records and the personal data of our patients for scientific dissemination, medical teaching, public communication, commercial promotion, advertising marketing, commercial exploitation and disclosure in general, unless they express the opposite at their surgery day booking by opting for the standard prices.
READ MORE ABOUT BENEFITS OF THE COLLABORATIVE MODEL
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Not included in standard quotations are, among others, non basic preoperative tests, pre and postoperative consultant referrals for assessment, additional garments, non hospital supplies (materials, drugs, etc.), postoperative tests and any kind of postoperative re-interventions, postoperative medical or surgical emergencies and costs exceeding the planned protocol of management like unplanned, unforeseeable and unavoidable extended surgical time rental of the operating room, extended hospital stay in standard ward or Intensive Care Unit (ICU) room and all the associated costs with any hospital-based assistance of complications, medicalized repatriation, hostelry accommodation, maintenance and travel costs; we do not take account of any costs not within the scheduled treatment pre and postoperative planned and agreed management.
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Due to the competitiveness scenario of the markets most plastic surgery clinics and plastic surgeons feel forced to invest large sums of money into advertising and marketing campaigns; this non medical additional cost is always and necessarily charged on top of the final price paid by patients, leading thus to an overprice of surgeries and treatments. No one patient wishes to bear that financial burden embedded in the surgical costs, furthermore neither surgeons nor clinics are happy to increase their retail prices and penalize their customers with costs not bringing any kind of special medical benefit, safety enhancements or results improvement; the promotion budget aims only to disseminate the public knowledge of a services provider and raise the awareness about its presence to potential customers, but not to make the service or the product a better one.
Seems like this model is a no-way-out labyrinth from which no one can be freed, furthermore it is such a tempting, easy and hassle-free way that actually most patients and plastic surgery providers are locked into it, happily or with resignation, paying a high price due to being non collaborative; however there is an ideal alternative, based on keeping up a good hard work based on a strive for providing quality service and achieving patients' satisfaction, which necessarily requires the decided support of the clients and somehow their involvement in such virtuous business model grounded on top-notch results
READ ABOUT BENEFITS OF THE COLLABORATIVE MODEL
When plastic surgery providers and patients do actively engage into a collaborative economy scenario a win-win basis is set for their relationship, since the clinics and surgeons obtain the best promotion ever possible with no budget for marketing investment and the patients get in return rid of any additional and unnecessary costs; such a price reduction does not represent any loss in the quality of the treatment they are receiving, furthermore this saving achieved will actually reward customers with a reinforced confidence and guarantee the service providers will strive to perform the best job possible and obtain results second to none.
It is not a paradox or contradiction; under a collaborative economy umbrella plastic surgery patients enjoy a greater plus of confidence that clinics and surgeons will do their very best and beyond to satisfy their customers, in spite the price is lower than in marketing-based non collaborative models; plastic surgery providers who found their business sustainability on the pillars of exclusively or mainly incremental budget investment in ongoing promotion campaigns do have little incentive in achieving first-class results and the best patient experiences, since their business model is not based on returning patients after word-of-mouth dissemination of their reputation but on the attraction of cold clients with sophisticated advertising methods of higher or lesser moral acceptability, attracting customers as parachutists randomly landing on unknown land, which is a perverse business model frequently leading to an unavoidable degradation of safety and results quality besides an uncontrollable increase in costs and prices; this marketing-based model creates no incentives to keep up the good work and pushes the prices higher on and on due to require increasing promotional investments.
On the other side, which is definitely our side, clinics and surgeons who rely solely or mostly their existence and survival in the competitive plastic surgery market enjoying the widespread of their excellence extended by their own patients results and satisfaction, like a mill driven by the winds of prestige, have the strongest ever incentive to be the best service providers around, sourced from the support of happy clients and their operated cases as proof of their excellent jobs; needless to say such supporters, the patients, have to enjoy a share of this benefit so that the incentive is reciprocal; under this scenario clinics and surgeons strive to provide the best service and accordingly patients release and transfer in a fair exchange the materials and tools required to build a marketing-budget-free and virtuous business model which creates the perfect incentives to build the best sponsorship-free reputation, based on the grounds of medical quality thus allowing prices control within affordability thanks to the minimal cost of its maintenance.
This is the deal; patients give in our favor the release and transfer of the intellectual property, the rights of image, the medical records and the personal data of their cases for scientific dissemination, medical teaching, public communication, commercial promotion, advertising marketing, commercial exploitation and disclosure in general, and they receive in exchange a compensating remuneration of a -20% discount from the standard price list for our treatments, as it is publicly visible by default in all the prices and quotations on our website.
As can be observed our visible prices are highly competitive if compared with other plastic surgery providers, actually the difference is approximately a -20% from the average price of each particular treatment in other clinics and surgeons from similar economical areas and countries of comparable development; this is not due to any quality or safety downgrading but to our collaborative business model; in other words, the budget which theoretically should be invested in marketing and promotion campaigns is discounted from the retail prices and, unlike other plastic surgery providers, is not wasted into pointless advertising to patients which entails no kind of added value for them; such campaigns are replaced with our superb results publicized thanks our patients support by letting us use their cases' Before & After and Intraoperative & Technical images and medical details; this explains that price gap between us and other clinics and surgeons.
READ LESS ABOUT BENEFITS OF THE COLLABORATIVE MODEL
Patients gain a highly affordable pricing model with yet world-class standards of medical practice, safety and results, and we gain competitiveness within the industry by means of saving the budget theoretically bound to be wasted in marketing.
Patients contribute with their images and medical details and we compensate them with a -20% discount from the expectable average price quoted by comparable clinics and surgeons.
We receive a boost of unbeatable promotion and market penetration by using our awesome operated cases and the patients enjoy a plus of guarantee that we will strive to conduct ourselves to the highest level of excellence and obtain results better than one can imagine.
We help you access the best plastic surgery results and you help us win the race of the market.
Should you feel not interested in collaborating with our business model and still wish to be our patient? No worries, this perfectly possible under the same philosophy of professionalism, devotion and quality, you have to simply express your opposition at surgery day booking by opting for the standard prices and thus give up the -20% discount of the collaborative model, budget which will be used to promote our business in sponsorships, campaigns or one-time actions aiming to attract new customers who, without your help to take the right decision for their surgery, may need sponsored channels to know about us.
Keep in mind that taking part in our collaborative business model is also an altruist way to help other prospective patients to find the medically right and commercially suitable plastic surgery provider, besides collaborating in the medical education of other surgeons and medical professionals.
We offer a flexible consumer-to-business relationship by letting our patients choose between a release & transfer quotation model in which the standard price list receives a -20% discount becoming thus the reduced price list, and a no disclosure quotation in which the standard price list applies and the patient misses such compensating remuneration.
Two models under the same quality involving different prices and marketing-building strategies; you receive always one guarantee: our commitment we will give you our best.
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